Mattie McGrath blasts patient transport cuts in rural Tipperary

Let's dive into the discussions shaping the nation. Access to hospital appointments in hospitals like Canmel, Limerick, Cork, Waterford and indeed Dublin depends entirely on the patient transport services provided by the HSE or in need by voluntary organisations which I salute for the work they do like the Red Cross, Civil Defence and the Order of Malta. These are not luxury services but they are essential lifelines. They have been contacted by family, I have been contacted by families, carers and community groups who are at breaking point. They are being told that transport is no longer available, that services are being rationalised, that lovely word, and in some cases that patients must find alternative arrangements but what alternatives do they have in rural parishes? Public transport in much of Tipperary is limited or non-existent, many of those patients are already frail, wheelchair users are recovering from major surgeries, they cannot drive themselves, they do not have family or family members that they may be walking or living around or they may be living abroad. The result is missed appointments, delayed treatments and worsening conditions and ultimately pressure piled back on our hospitals due to avoidable admissions to A&Es. I had one case where a man waited four years, four years minister, 48 months for an appointment, he has no family, his neighbour who used to bring him to his appointments had passed away a month ago and he had no one else to transport him to Cork. He was too frail to use public transfers as it was non-existent in the first place and in any event a taxi would cost him €120, half of his pension gone and won a pint. Such a shocking situation minister. Another case of a woman whose daughter is paraplegic and requires an ambulance transfer. This woman literally had no other option, she could not just get a neighbour to drive her, in the end she was forced to beg a voluntary organisation to get them to transport her daughter to a vital appointment which did happen and thankfully for that for the volunteers and the ambulances. Minister, this is not a question of convenience, this is about dignity, quality of access and the right to timely medical care, regardless of your address on the income. I want to ask you today minister, who made this decision unilaterally, to cut this without any engagement, why was the cuts made with no public consultation, no dialogue debate and no local engagement or local engagement, where is the assessment of the human cost to this and will the minister commit to immediately reviewing the criteria for access to patient transport services temporarily with a view to restoring full service. How can faithless bureaucrats, how can faithless bureaucrats decide this? When I came in here in 2007 with the agency the budget had around £7 billion, now it's £24 billion and growing every year, and how come it's the most vulnerable? We had a five-hour debate here today, we had a five-hour debate about what Carol Darmony was here with her dad, about people's access to and the HSE breaking the law on a daily hourly basis and not doing assessments of needs. So why are we going to allow this cabal in the HSE to run amok, do what they like, neglect people and flout the laws? First of all I want to thank you Deputy McGrath for, you know I suppose what you brought up tonight highlights an issue that it's a concern and I just want to give you an update on the patient transport in County Tipperary. So the patient transport service which provides non-emergency patient transport for some patients in the South East region was set up in 2013. It was set up on a discretionary basis by the HSE for the South East region. Hospitals in this region were given a budget to provide limited transport for patients to attend other acute services. The cost of providing the non-emergency patient transport services has increased year on and the cost for providing these services has grown from just over 88,000 in 2019 to over 127,000 in 2024. Due to this continued increase Tipperary University Hospital has had to review the eligibility criteria for patients applying for access to the service. The review of the eligibility criteria is aimed at preserving the valuable service so that those most in need and the vulnerable patients can access it. It is important to emphasise that those patients travelling for radiation therapy or chemotherapy will not be affected by these changes. That is important to clarify today Deputy. There are a number of criteria which need to be taken into consideration by Tipperary University Hospital when assessing a patient's eligibility to access the service. including the patient's exceptional medical need and the patient's age 75 years and over, mobility appointment and so on. The Government fully acknowledges the concern and inconvenience for patients and their families that these changes have made to Tipperary University Hospital. It continues to accommodate the patients most in need of this service in line with the revised eligibility criteria. The hospital robustly assesses patients' eligibility and all patients must meet the revised criteria before being approved for the transport. The assessment of patients' eligibility for non-emergency patient transport services is determined by the local HSE service, who aims to provide those most in need of access to this valuable service. The government has invested significantly in Tipperary University Hospital and the budget for the hospital has increased from almost 81 million in 2020 to over 122 million in 2025. A significant increase of 51 per cent in this time. Staffing Deputy has also increased by 25 per cent since 2020 from 968 to 1,212. The cost of providing this important service has increased year-on and it aims at assisting those most in need. Thank you Deputy. Mr. Duke, I remember six months ago you were in opposition, you were like myself, crying out about this. It is not a massive increase, it is 88,220 over since 2013. There is nothing in the scheme of things. And you are missing all this to staff. I want to know how many more pen pushers, executives, going around with creating jobs, making up jobs. That is what they are. Not nurses or frontline staff. And it is a shocking situation. I stood in town at the front of St. Joseph's Hospital. We are opening a street in the morning wing. I want to go now. And the amount of new executives I met. Many from your area. No disrespect to them. But positions that we never had before. Executives of directors and directors of this and directors of that. Directors of everything. Except patient care. So we are taking on people. Of course we are. In managing jobs. Self-serving officials. This is what is wrong in the HSE. And we have spineless ministers that won't challenge them. We have been five hours a night talking about it here. All sides of the House condemning what is going on in the HSE. And then we have this mean, hungry, desperate cuts to people who are vulnerable. Thankfully they get collected for radium or other treatment. But what about the person who has a paraplegic or has an amputee. Or what about the people who have severe diabetes or many other conditions. So we are picking and choosing who is sick and who is vulnerable. While the cat is getting fatter. And we have the board members of the HSE. And we have the runway cost of the children in the hospital. And the absolute disgrace for the diabolical lack of management. And lack of accountability. And we make these mean cuts. We talked about a roughly dozen cuts. There was a Charlie McFeely back in the past. It is so mean. So mean-spirited. And we expect voluntary organisations to order more to civil defence. And indeed, as I said, Red Cross. To burn out their ambulances. Burn out their staff who are volunteers. And while there are, as I said, officials and fat cats going around to conferences. And everything else would vote. Bring back the maidens to the hospital. And make the savings there. And have the hospitals clean. And not have plenumers of management who are not managing. They are incapable. They were never managed in the first place. Some of them have gone into those jobs pulled in by pull. And it is a shocking situation that we can treat people like this. Vulnerable people in our society. And you cannot argue against it. First of all, again, I want to thank you, Deputy, for raising this issue and providing with the opportunity to update you on the transport in County Tipperary. And I think it is important, Deputy, when you mention the Red Cross, Order of Malt and Civil Defence, that we pay tribute to the great work that they do. They are absolutely excellent. And, you know, I think it was important that you recognise them. And that we all recognise them tonight. But I can assure you, Deputy, that the HSE and Tipperary University Hospital are committed to providing high-quality service in response to the local needs. Tipperary University Hospital has reviewed the eligibility criteria for the non-emergency patient transport service so that the most in need and vulnerable patients can still access this. And, as I said earlier, Deputy, the non-emergency patient transport calls are planned for patients who require transport in a special converted taxi or minibus to attend pre-arranged medical appointments and who do not require a stretcher-equipped vehicle. The patient transport service set up in 2013 on a discretionary basis by the HSE provides non-emergency patient transport for patients in the south-east region hospitals. And, you know, there is a budget there. I do understand your concerns, Deputy, I really do. I will go back to the HSE for you and see if, you know, it can be looked at. I will do that because I do understand that there is vulnerable people out there. And it is important to reiterate that this is HSE-led. And, as I said, thank you for highlighting the seriousness and the concerns that you have raised tonight. Thank you very much. Like, share, and subscribe, and let us know your thoughts in the comments. We'd love to hear from you.